Surgery

Gastric bypass Roux-en-Y
The Roux-en Y works by decreasing food intake, limiting the amount of food the stomach can hold by closing off a significant portion of the stomach and delaying the emptying of the stomach (gastric pouch).In this operation the stomach is divided into two compartments with several rows of titanium staples. The newly created stomach pouch is measured at less than 30 cc's. The small intestine is then divided in the proximal jejunum and the lower end brought up and joined to the new small stomach compartment. The pouch initially holds about 1 ounce of food and expands to 2-3 ounces with time. The pouch's lower outlet usually has a diameter of about 1/2-inch. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness. After an operation, the person usually can eat only 5 to 10 bites of food before feeling full. With time, the capacity may increase to half to a whole cup of food that may be consumed without discomfort or nausea. Food has to be well chewed. For most people, the ability to eat a large amount of food at one time is lost, and some of the food consumed will not be absorbed due to the bypass segment of the operation.

Adjustable gastric band: A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device that is placed around the top portion of the stomach.Gastric banding is commonly performed using laparoscopic surgery. Because no part of the stomach is stapled or removed, and the patient’s intestines are not re-routed, he or she can continue to absorb nutrients from food normally. Gastric bands are made entirely of biocompatible materials, so they are usually able to stay in the patient’s body without causing harm. Not all patients are suitable for this procedure. Patients who are extremely obese, who have had previous abdominal surgery, or have other medical problems may require a different surgical option.

The placement of the band creates a small pouch at the top of the stomach. This pouch holds approximately ½ cup of food, whereas the typical stomach holds about 6 cups of food. The pouch fills with food quickly, and the band slows the passage of food from the pouch to the lower part of the stomach.As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full, and this sensation helps the person to be hungry less often, feel full more quickly and for a longer period of time and eat smaller portions.

As patients lose weight, their bands may need adjustments, or “fills,” to ensure comfort and effectiveness.